Italian Cheese Club Signup Form

Yes! I would like to join the Italian Cheese Club and receive 1 lb (2 X 1/2 lbs per cheese selection) or 2 lb (2 x 1 lbs per cheese selection) of gourmet Italian cheese per shipment.

. For orders placed after the 10th of the month, the club membership will start the following month.
. Your credit card will be automatically charged every month, one week prior to each shipment unless you select the prepaid option (then it is charged once).
· You can cancel your membership at any time.

Please click here to read important shipping and handling information.
If you have any questions, please email or call 212.889.4168 from 12 PM to 4 PMEST.

Just fill out this form to receive membership in the Italian Cheese Club and start receiving the best in Italian cheese!
ALL REQUIRED FIELDS HAVE AN ASTERISK*

Select how often you would like your shipments to be sent:*

Monthly

Every other month

Type of Payment: Prepaid

Choose the number of shipments you would like to send: *

Three shipments

Six shipments

Twelve shipments

Open choice*

*in order to cancel you must call 212.889.4168 from 12 PM to 4 PMEST.

The cost of each selection includes one pound or two pounds of cheese. Please choose from one of the following. *

Singolo: $21.99 / 1 lb (2 x 1/2 lb) + shipping & handling

Doppio: $34.99/ 2 lbs (2 x 1lb) + shipping & handling

Please choose your shipping area from the following. *

Area I: CT, DE, GA, IA, IL, IN, KY, MA, MD, ME, MI, NC, NH, NJ, NY, OH, PA, RI, SC, TN, VA, VT, WV

Area II: AL, AR, AZ, CA, CO, FL , ID, KS, LA, MN, MO, MS, MT, ND, NE, NM, NV, OK, OR, SD, TX, UT, WA, WI, WY

Area III: AK, HI

We do not ship outside of the U.S.

Billing information:

Ship To (if different from Bill To)

First Name *
Last Name *
Address *
City *
State *
Zip Code *
Day Tel *
Fax Number
E-mail *

First Name
Last Name
Address
City
State
Zip Code
Daytime Tel

Please enter your credit card information. Your credit card will be charged on a monthly or bi-monthly basis at the time of shipping. *

Please note that this is a secure site.
www.Italiancookingandliving.com uses Secure Socket Layer (SSL) technology for all online transaction. SSL encrypts your personal information such as name, address and credit card number in an effort to prevent unauthorized access of this information during the transmission of your online order.

Card Type

Card Number

Exp. Date /

Are you a subscriber to the following magazines or a member of the following clubs? (Check any that apply)

Italian Cooking & Living magazine	Italian Table Club
Italian Wine of the Month Club (Morrell & Co)	Italian Olive Oil Club

How did you hear about the Italian Cheese Club?

Do you have any questions or comments? (do not skip lines, maximum length of 2 lines)